Young adults with depression are at increased risk of sexually transmitted disease

Sexually transmitted diseases (STDs) and depression impact millions of individuals each year in the United States, with direct medical costs exceeding $41 billion. While the interactions of these conditions are poorly understood, they are increasingly addressed in primary care whereas historically they have been addressed separately. 

We analyzed data associated with the 18-25 year age group from the 2014 National Survey of Drug Use and Health, a cross-sectional survey of the civilian, non-institutionalized US population aged ≥12 years for factors associated with past year diagnosis of STD (STDy). Independent variables included participant demographics; lifetime diagnosis of major depressive episode (MDE); participant behaviors associated with STD risk (patient-provided); and medical record data associated with mental illness treatment (clinically-observed). 

Of 18,142 participants, the prevalence of MDE and STD was 15.3% and 2.4%, respectively, with significant differences by gender and race. MDE was associated with increased risk of STDy among females (odds ratio [OR]=1.61; 95% confidence interval [CI]=1.18-2.20), males (OR=2.32; CI=1.15-4.70), those of white race (OR=3.02; CI=2.02-4.53), and lower income levels and insurance status. Univariate modeling found that receiving mental health treatment, and use of marijuana, alcohol, and illegal drugs were each associated with significantly increased STDy. 

In a multivariate logistic regression, receiving mental health treatment became protective for STDy (AOR=0.55; CI=0.32-0.95]). Individuals with a history of depression are at increased risk of STDy, with this risk modified by factors readily ascertained within primary care. As depression treatment is increasingly incorporated into primary care there are means to more effectively target intervention resources.

Purchase full article at:   http://goo.gl/54KWZB

By:  Jenkins WD1, Botchway A2.

• 1Population Health Science Program, Southern Illinois University School of Medicine, 801 N. Rutledge St, Springfield, IL 62794-9664, United States. Electronic address: wjenkins@siumed.edu.
• 2Center for Clinical Research, Southern Illinois University School of Medicine, 801 N. Rutledge St, Springfield, IL 62794-9664, United States. 
• Prev Med. 2016 Apr 4. pii: S0091-7435(16)30042-1. doi: 10.1016/j.ypmed.2016.03.020

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Poor CD4 Count Is a Predictor of Untreated Depression in HIV-Positive African-Americans

AIM:

To determine if efforts to improve antiretroviral therapy (ART) adherence minimizes the negative impact of depression on human immunodeficiency virus (HIV) outcomes.

METHODS:

A cross-sectional study of a clinic-based cohort of 158 HIV seropositive (HIV+) African Americans screened for major depressive disorder (MDD) in 2012. CD4 T lymphocyte (CD4+) counts were obtained from these individuals. Self-report on adherence to ART was determined from questionnaire administered during clinic visits. The primary outcome measure was conditional odds of having a poorer CD4+ count (< 350 cells/mm(3)). Association between CD4+ count and antidepressant-treated or untreated MDD subjects was examined controlling for self-reported adherence and other potential confounders.

RESULTS:

Out of 147 individuals with available CD4+ T lymphocyte data, 31% hadCD4+ count < 350 cells/mm(3) and 28% reported poor ART adherence. As expected the group with > 350 cells/mm(3) CD4+ T lymphocyte endorsed significantly greater ART adherence compared to the group with < 350 cells/mm(3) CD4+ T lymphocyte count (P < 0.004). Prevalence of MDD was 39.5% and 66% of individuals with MDD took antidepressants. Poor CD4+ T lymphocyte count was associated with poor ART adherence and MDD. Adjusting for ART adherence, age, sex and education, which were potential confounders, the association between MDD and poor CD4+ T lymphocyte remained significant only in the untreated MDD group.

CONCLUSION:

Therefore, CD4+ count could be a clinical marker of untreated depression in HIV+. Also, mental health care may be relevant to primary care of HIV+ patients

Demographic and behavioral characteristics of study participants with or without depression

Characteristics	No MDD	MDD treated	MDD untreated	P
	(n = 89)	(n = 38)	(n = 20)
	(%)	(%)	(%)
Gender
Male	63.27	50	60	0.35
Female	36.73	50	40
Age groups
> 55	24.49	5	15	0.12
35-55	62.24	77.5	70
< 35	13.27	17.5	15
Monthly income
0-200	32.61	30.77	33.33	0.32
204-670	17.39	25.64	5.56
672-739	21.74	30.77	27.78
743-2650	28.26	12.82	33.33
Educational status
No college	70.59	78.57	72.73	0.73
College	29.41	21.43	27.27
Accommodation
Yes	60.42	72.50	70	0.35
No	39.58	27.50	30
HIV treatment adherence
No	26.53	25	45	0.51
Yes	48.98	52.50	40
Unknown	24.49	22.50	15
Substance abuse
No	41.84	30	45	0.37
Yes	58.16	70	55
Problem drinking
No	72.45	53.85	45	0.02
Yes	27.55	46.15	55

HIV: Human immunodeficiency virus; MDD: Major depressive disorder.

Full article at:   http://goo.gl/7ob6Eo

By:  Amanor-Boadu S1, Hipolito MS1, Rai N1, McLean CK1, Flanagan K1, Hamilton FT1, Oji V1, Lambert SF1, Le HN1, Kapetanovic S1, Nwulia EA1.

1Sasraku Amanor-Boadu, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, United States

World J Psychiatry. 2016 Mar 22;6(1):128-35. doi: 10.5498/wjp.v6.i1.128. eCollection 2016.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Prevalence of Depressive Symptoms in Pregnant & Postnatal HIV-Positive Women in Ukraine

BACKGROUND:

Perinatal depression among HIV-positive women has negative implications for HIV-related and other maternal and infant outcomes. The aim of this study was to investigate the burden and correlates of perinatal depression among HIV-positive women in Ukraine, a lower middle income country with one of the largest HIV-positive populations in Europe.

METHODS:

Cross-sectional surveys nested within the Ukraine European Collaborative Study were conducted of HIV-positive women at delivery and between 1 and 12 months postpartum. Depressive symptoms in the previous month were assessed using a self-report screening tool. Other data collected included demographics, antiretroviral therapy (ART)-related self-efficacy, and perceptions of risks/benefits of interventions to prevent mother-to-child transmission (PMTCT). Characteristics of women with and without a positive depression screening test result were compared using Fisher's exact test and χ(2) test for categorical variables.

RESULTS:

A quarter (27 % (49/180) antenatally and 25 % (57/228) postnatally) of participants screened positive for depressive symptoms. Antenatal risk factors were living alone (58 % (7/12) vs 25 % (42/167), being somewhat/terribly bothered by ART side effects (40 % (17/43) vs 23 % (30/129) not /only slightly bothered, p = 0.05) and having lower ART-related self-efficacy (43 % (12/28) vs 23 % (25/110) with higher self-efficacy, p = 0.05). 

Postnatally, single mothers were more likely to screen positive (44 % (20/45) vs 21 % (18/84) of cohabiting and 19 % (19/99) of married women, p < 0.01) as were those unsure of the effectiveness of neonatal prophylaxis (40 % (20/45) vs 18 % (28/154) sure of effectiveness, p < 0.01), those worried that neonatal prophylaxis could harm the baby (30 % (44/146) vs 14 % (10/73) not worried p < 0.01) and those not confident to ask for help with taking ART (48 % (11/23) vs 27 % (10/37) fairly confident and 15 % (4/26) confident that they could do this). 

Of women who reported wanting help for their depressive symptoms, 82 % (37/45) postnatally but only 31 % (12/39) antenatally were already accessing peer counselling, treatment adherence programmes, support groups or social services.

CONCLUSIONS:

A quarter of women screened positive for depression. Results highlight the need for proactive strategies to identify depressive symptoms, and an unmet need for provision of mental health support in the perinatal period for HIV-positive women in Ukraine.

Below:  Responses to three depression screening questions

Purchase full article at:   http://goo.gl/xNDFrB

By:  Bailey H1, Malyuta R2, Semenenko I2, Townsend CL3, Cortina-Borja M3, Thorne C3; Ukraine European Collaborative Study in EuroCoord.

• 1Population, Policy and Practice Programme, UCL Institute of Child Health, University College London, London, UK. heather.bailey@ucl.ac.uk.
• 2Perinatal Prevention of AIDS Initiative, Odessa, Ukraine.
• 3UCL Institute of Child Health, University College London, London, UK.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

The Relationship Between Sexual Activity and Depressive Symptoms in Lesbian, Gay, and Bisexual Youth: Effects of Gender and Family Support

There is considerable debate over whether adolescent sexual activity is maladaptive and associated with worse mental health outcomes versus a positive developmental milestone that is associated with better mental health outcomes. Although these perspectives are often pitted against one another, the current study employed a more integrative perspective: adolescent sexual activity may be maladaptive in certain contexts, but healthy in other contexts. 

We investigated whether family support and gender moderated the relation between sexual activity and mental health outcomes in a diverse sample of 519 lesbian, gay, and bisexual (LGB) youth. Specifically, we examined whether youth who engaged in more sexual activity would have fewer depressive symptoms in the context of a more supportive family environment, but more depressive symptoms in the context of a less supportive family environment and whether this effect was stronger for sexual minority girls. Consistent with the sexual health perspective, we found that among girls with more family support, those who engaged in more frequent same-sex sexual contact had lower levels of depressive symptoms. 

Unexpectedly, we found that among boys with more family support, those who engaged in more frequent same-sex sexual contact had higher levels of depressive symptoms. In contrast, girls and boys with less family support showed no relation between sexual activity and depressive symptoms. 

Overall, results suggest that context is critical when determining whether same-sex sexual contact among LGB youth should be considered maladaptive or beneficial.

Purchase full article at:   http://goo.gl/xzH97X

By:  Dickenson JA1, Huebner DM2.

• 1Department of Psychology, University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT, 84112-0251, USA. janna.dickenson@psych.utah.edu.
• 2Department of Psychology, University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT, 84112-0251, USA. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Food Insecurity in HIV-Hepatitis C Virus Co-Infected Individuals in Canada: The Importance of Co-Morbidities

While research has begun addressing food insecurity (FI) in HIV-positive populations, knowledge regarding FI among individuals living with HIV-hepatitis C virus (HCV) co-infection is limited. 

This exploratory study examines sociodemographic, socioeconomic, behavioral, and clinical factors associated with FI in a cohort of HIV-HCV co-infected individuals in Canada. We analyzed longitudinal data from the Food Security and HIV-HCV Co-infection Study of the Canadian Co-infection Cohort collected between November 2012-June 2014 at 15 health centres. FI was measured using the Household Food Security Survey Module and classified using Health Canada criteria. Generalized estimating equations were used to assess factors associated with FI. 

Among 525 participants, 59 % experienced FI at their first study visit (baseline). Protective factors associated with FI (p < 0.05) included: enrolment at a Quebec study site, employment, and average personal monthly income. Risk factors for FI included: recent injection drug use, trading away food, and recent experiences of depressive symptoms. 

FI is common in this co-infected population. Engagement of co-infected individuals in substance use treatments, harm reduction programs, and mental health services may mitigate FI in this vulnerable subset of the HIV-positive population.

Purchase full article at:   http://goo.gl/d20K1v

By:  Cox J1,2,3, Hamelin AM4, McLinden T4, Moodie EE4, Anema A5,6, Rollet-Kurhajec KC7, Paradis G4, Rourke SB8,9,10, Walmsley SL11,12, Klein MB7; Canadian Co-infection Cohort Investigators.

• 1Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, QC, H3A 1A2, Canada. joseph.cox@mcgill.ca.
• 2Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada. joseph.cox@mcgill.ca.
• 3CIHR Canadian HIV Trials Network, Vancouver, BC, Canada. joseph.cox@mcgill.ca.
• 4Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, QC, H3A 1A2, Canada.
• 5Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
• 6Department of Medicine, Boston Children's Hospital, Boston, MA, USA.
• 7Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.
• 8Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
• 9The Ontario HIV Treatment Network, Toronto, ON, Canada.
• 10Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
• 11Department of Medicine, University of Toronto, Toronto, ON, Canada.
• 12Division of Infectious Diseases, University Health Network, Toronto, ON, Canada. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Pain-Related Anxiety in Relation to Anxiety & Depression among Persons Living with HIV/AIDS

Persons living with HIV/AIDS (PLHA) experience clinically significant pain as a result of HIV and such pain is often related to increased levels of anxiety/depression. Pain-related anxiety has been identified as a mechanism in the onset and progression of pain experience and associated affective distress. However, there has not been empirical study of pain-related anxiety in relation to affective processes among PLHA. 

To address this gap, hierarchical multiple regressions were conducted using SPSS v.21 to examine pain-related anxiety (as measured using the Pain Anxiety Symptoms Scale) in relation to anxiety and depressive symptoms (as measured using the Mood and Anxiety Symptoms Questionnaire) among 93 PLHA (10.8% female; Mean age = 49.63, SD = 8.89). Pain-related anxiety was significantly related to anxious arousal symptoms (β = .43) and anhedonic depressive symptoms (β = .25); effects were evident beyond the variance accounted for by CD4 count, race, sex, income level, and current level of bodily pain. 

The present results suggest that pain-related anxiety may play a role in the experience of anxiety and depressive symptoms among PLHA.

Purchase full article at:   http://goo.gl/F7jBYN

By:  Brandt CP1, Zvolensky MJ1,2, Daumas SD1, Grover KW3, Gonzalez A4.

• 1 Department of Psychology , University of Houston , Houston , TX , USA.
• 2 Department of Behavioral Sciences , University of Texas MD Anderson Cancer Center , Houston , TX , USA.
• 3 Department of Psychology , University of Vermont , Burlington , VT , USA.
• 4 Department of Psychiatry , Stony Brook University , Stony Brook , NY , USA. 
• AIDS Care. 2016 Apr;28(4):432-5. doi: 10.1080/09540121.2015.1100704. Epub 2015 Oct 18.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Disparities in Depressive Symptoms Between Heterosexual and Lesbian, Gay, and Bisexual Youth in a Dutch Cohort: The TRAILS Study

Lesbian, gay, and bisexual (LGB) youth experience elevated levels of depressive symptoms compared to heterosexual youth. 

This study examined how differences in depressive symptoms between heterosexual and LGB youth developed from late childhood to early adulthood. The association between sexual orientation and depressive symptoms was estimated from age 11 to 22 using data from the TRacking Adolescents’ Individual Lives Survey, a longitudinal Dutch cohort study. 

Of the 1738 respondents (54.8 % girls) that provided information on sexual orientation, 151 self-identified as LGB. In line with the Minority Stress Framework, it was tested whether self-reported peer victimization and parental rejection mediated the association between sexual orientation and depressive symptoms. 

Results indicated that LB girls and bisexuals were at increased risk of depressive symptoms already at age 11. The difference increased over time and was related to pubertal development in girls and bisexual individuals. 

Furthermore, self-reported peer victimization (for both boys and girls), as well as parental rejection (for girls/bisexuals), mediated the association between sexual orientation and depressive symptoms. 

The authors conclude that already in late childhood, associations between sexual orientation and depressive symptoms are found, partly due to minority stress mechanisms.

Below:  Depressive symptoms by sexual orientation and gender

Below:  Depressive symptoms for heterosexuals, gays/lesbians and bisexuals

Full article at:   http://goo.gl/IsVjwp

By:  Chaïm la Roi, Tina Kretschmer, Jan Kornelis Dijkstra, René Veenstra, and Albertine J. Oldehinkel

Department of Sociology, Interuniversity Center for Social Science Theory and Methodology (ICS), University of Groningen, Grote Rozenstraat 31, 9712 TG Groningen, The Netherlands

Department of Pedagogy and Educational Science, University of Groningen, Grote Rozenstraat 38, 9712 TJ Groningen, The Netherlands

Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands

Chaïm la Roi, Phone: +31503638938, Email: ln.gur@ior.al.c.

Corresponding author.

J Youth Adolesc. 2016; 45: 440–456. Published online 2016 Jan 9. doi:  10.1007/s10964-015-0403-0

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Methamphetamine Use Is Associated with High Levels of Depressive Symptoms in Adolescents & Young Adults in Rural Chiang Mai Province, Thailand

BACKGROUND:

High levels of depressive symptoms often occur among individuals that use or that are dependent on methamphetamine (MA). Thailand is currently experiencing an epidemic of MA use among youth. Understanding the nature of the relationship between depressive symptoms and MA use and identifying those most at risk can further understanding of prevention and treatment options for youth who use MA and present with depressive symptoms.

METHODS:

In 2011, we conducted a cross sectional epidemiologic study that examined associations between MA use and high levels of depressive symptoms among adolescents and young adults aged 14-29 living in Chiang Mai province, Thailand. A combination of cluster and systematic sampling was conducted to obtain a study sample of participants actively recruited in Chiang Mai province. Depressive symptoms were measured using a Thai translation of the Centers for Epidemiologic Studies Depression scale (CES-D). The independent variables measured reported lifetime and recent MA use within the past 3 months. Multivariate logistic regression models were used to assess associations between MA use and high levels of depressive symptoms.

RESULTS:

Approximately 19 % (n = 394) of the sample reported ever having consumed MA and 31 % (n = 124) of lifetime users reported recent MA use within the past 3 months. Recent MA use was associated with high levels of depressive symptoms (aPOR recent use: 2.60, 95 % CI: 1.20, 5.63).

CONCLUSIONS:

This is one of the first studies to examine the association between MA use and high levels of depressive symptoms in a general Thai population. The odds of having high levels of depressive symptoms was significantly greater among recent MA users compared to non-users. These findings support the need for policies, programs and interventions to prevent and treat depressive symptoms presenting among MA using Thai adolescents and young adults in rural Chiang Mai province, Thailand to aid in cessation of MA use. Furthermore, additional research is needed to investigate treatment options for adolescents and young adults in Thailand that use MA and present with high levels of depressive symptoms

Full article at:   http://goo.gl/OC9Y3z

By:  DiMiceli LE1, Sherman SG2, Aramrattana A3, Sirirojn B4, Celentano DD5.

• 1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA. ldimice1@jhu.edu.
• 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA. ssherman@jhsph.edu.
• 3Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand. apinun@mail.med.cmu.ac.th.
• 4Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand. bangorn.s@cmu.ac.th.
• 5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA. dcelent1@jhu.edu. 
• BMC Public Health. 2016 Feb 19;16(1):168. doi: 10.1186/s12889-016-2851-1.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health